TDO2+ myofibroblasts mediate immune suppression in malignant transformation of squamous cell carcinoma

Characterization of the dynamic change in the immunological landscape during malignant transformation from precancerous lesions to cancerous lesions in squamous cell carcinoma (SCC) is critical for the application of immunotherapy. Here, we performed single-cell RNA-Seq (scRNA-Seq) of 131,702 cells from 13 cancerous tissues of oral squamous cell carcinoma (OSCC), 3 samples of precancerous oral leukoplakia, and 8 adjacent normal samples. We found that tumor-infiltrating CD4· and CD8· T cells were functionally inhibited by immunosuppressive ligands expressed on various types of myeloid cells or neutrophils in the process of oral carcinogenesis. Notably, we identified a subset of myofibroblasts that exclusively expressed tryptophan 2,3-dioxygenase (TDO2). These TDO2· myofibroblasts were located distally from tumor nests, and both CD4· and CD8· T cells were enriched around them. Functional experiments revealed that TDO2· myofibroblasts were more likely to possess the ability for chemotaxis toward T cells but induced the transformation of CD4· T cells into Tregs and caused CD8· T cell dysfunction. We further showed that use of the TDO2 inhibitor LM10 attenuated the inhibitory states of T cells, restored the T cell antitumor response, and prevented the progression of OSCC malignant transformation in murine models. Our study reveals a multistep transcriptomic landscape of OSCC and demonstrates that TDO2· myofibroblasts are potential targets for immunotherapy.